This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. A dramatic global resurgence of infectious diseases has occurred during the past 25 years, such that infectious diseases have regained their position as the leading cause of morbidity and mortality worldwide. Moreover, infectious diseases are among the most important public health and economic problems facing the Asia-Pacific region at the beginning of the new millennium. Unbridled population growth and widespread environmental upheaval throughout Asia and Oceania, along with the insidious breakdown of the public health infrastructure, have contributed to the resurgence of infectious diseases. Movements of people, animals and insect vectors via jet travel have also greatly facilitated the dissemination of infectious diseases. A recent example is the outbreak of dengue fever in Hawaii in 2001, after a hiatus of nearly 60 years. Thus, heightened capacity for infectious diseases surveillance is urgently needed. The strategic geographic location and strong ties to resource-poor developing countries in the Asia-Pacific region places the University of Hawaii at Manoa in a unique position to monitor the emergence or introduction and spread of newly recognized infectious diseases, such as Nipah virus encephalitis and severe acute respiratory syndrome (SARS). Against this backdrop, the Pacific Center for Emerging Infectious Diseases Research is being developed as a multi-disciplinary center of excellence for research and training in infectious diseases and as a regional reference center for the diagnosis and control of new, emerging and re-emerging microbial threats. Investigations will focus on the risk factors associated with acquisition of infection with human papillomaviruses (which cause cervical cancer in women) and group A streptococci (which cause acute rheumatic fever). In addition, the immune responses to dengue viruses will be studied, as part of a larger program aimed at conducting vaccine efficacy trials. In addition, studies will focus on the development of improved rapid diagnostic tests for medically important microbial diseases. Each of these infectious diseases is of local and regional importance and disproportionately affect under-served ethnic minorities and disadvantaged or marginalized communities in Hawaii and the Asia-Pacific region. Outbreaks of avian influenza virus (H5N1 or "bird flu") infection in domestic fowl and migratory birds have now been reported in more than 60 countries worldwide. Although the number of H5N1 infections in humans has been relatively low (with most of the 200 cases occurring thus far in Vietnam, Indonesia and Thailand), the high mortality rate of nearly 50% has heightened fear and produced growing anxiety that the next human influenza pandemic will emerge. That the 1918 H1N1 pandemic was of avian origin has further fueled concern. These current events in Asia pose a real threat to the public health of Pacific Island nations as well as the Americas, by virtue of rapid and unrestricted jet travel and the known flyways of migratory wild birds. Moreover, the current and future economic toll is enormous. With the establishment of the Pacific Center for Emerging Infectious Diseases Research, as a multi-disciplinary center of excellence for research and training in infectious diseases, the University of Hawai'i at Manoa will be well positioned to make meaningful contributions to the study of such new, emerging and re-emerging microbial threats, especially those originating in southeast Asia. Specific Aim 1. Build institutional capacity by mentoring a cadre of promising young faculty to conduct research on infectious diseases of medical importance to the Asia-Pacific region. Specific Aim 2. Improve research competitiveness by enhancing the capacity for mentoring and expanding the capability of the technical support infrastructure. Specific Aim 3. Diversify the research breadth and trans-disciplinary scope of the Center through targeted recruitment and retention of funded faculty with complementary expertise and through centralization of laboratory space and research-support operations.